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Should President Trump end 'chain migration?'

PAINTSVILLE, Ky.Attempts to open methadone clinics for drug addicts have spawned protests and even court fights in some places, but not in Appalachia.Residents and political leaders, grappling with an epidemic of OxyContin addictions, welcomed at least 10 methadone clinics in a region that previously had none.One of the newest clinics opened in the former office of a Paintsville physician who was arrested last year for reportedly overprescribing OxyContin and other painkillers to patients in eastern Kentucky.The change of tenants has had a dramatic effect in the small town. Traffic jams disappeared around Jefferson Avenue, where people seeking prescription drugs used to park. The parking lot of the methadone clinic has remained uncrowded and calm.Police Chief Doug Wallen said he expected an outcry when the methadone clinic opened. "We haven't had the first complaint," he said.Clinics opened without opposition in the Kentucky cities of Hazard, Morehead and Corbin, in Cedar Bluff, Va., and in the West Virginia cities of Charleston, Clarksburg, Parkersburg, Martinsburg and Beckley.Clinics have opened in the Virginia cities of Richmond and Charlottesville, as well as other cities outside central Appalachia, to serve people addicted to OxyContin and other opioids.OxyContin became popular in eastern Kentucky because of the economically depressed areas, police said. Residents with insurance or Medicaid could obtain the pills free of charge. The drug's popularity has grown because of its quick high that produces effects similar to those of the more expensive drug heroin.In some communities outside Appalachia, methadone clinics haven't been so warmly welcomed because of concerns that addicts may bring an increase in criminal activity in the neighborhoods where they locate.An attempt to open a methadone clinic in Covington, Ky., a Cincinnati suburb, spawned a four-year court battle that ended in June when the 6th U.S. Circuit Court of Appeals ruled in favor of the clinic. City officials, responding to the concerns of residents, had gone so far as to amend a zoning ordinance to keep the clinic from opening."Methadone can be controversial because some people see it as trading one drug for another drug," said Merritt Moore, adult-treatment coordinator in the West Virginia Division of Alcoholism and Drug Abuse. "These clinics opened without fanfare. It went smoothly."Eastern Kentucky sociologist Roy Silver said nearly everyone in mountain communities has been affected in some way by OxyContin abuse, often because a friend or relative has become hooked. The methadone clinics have been welcomed, he said, because of the perceived help they can provide."OxyContin abuse has been so devastating," Mr. Silver said. "It's the most serious drug problem that's ever hit the region, and that's why people are more amenable to having something like this in their communities."